EMS on the Hill Day: Five Years of Advocacy

On March 25–26, the National Association of Emergency Medical Technicians (NAEMT) celebrated a milestone, hosting the fifth annual EMS on the Hill Day in Washington, D.C.

Last year a powerful winter storm hampered efforts. This year the threat of snow didn’t materialize, but strong winds and chilly temperatures sent nearly 200 EMS professionals from 42 states and the District of Columbia and Puerto Rico dashing from one building to the next to keep their scheduled appointments with members of Congress. EMS practitioners, managers, educators and physicians from a variety of delivery models attended a record 248 congressional meetings in a single day. During each meeting they shook hands, posed for photos and educated congressional leaders and their staff on the Field EMS Quality, Innovation and Cost-Effectiveness Improvements Act (H.R. 809); membership in the Congressional EMS Caucus; and the Medical Preparedness Allowable Use Act (H.R. 1791). The primary push, however, was H.R. 809, also known as the field EMS bill.

”The best thing is that lots of people knew who we were and remembered us from last year,” says NAEMT President Don Lundy, NREMT-P. “I met people who said, ‘I was reviewing your bill.’ That was great!”

The field EMS bill, sponsored in the House by Indiana Rep. Larry Bucshon with bipartisan support from more than 20 colleagues, addresses a number of systemic problems identified by the landmark 2006 Institute of Medicine (IOM) report Emergency Medical Services: At the Crossroads. Key among those is establishing a primary federal agency for EMS and trauma. The bill names the U.S. Department of Health and Human Services (HHS) as that lead agency.

Lundy says HHS is the right fit in light of the significant changes in healthcare. “EMS is emergency medical services,” he says. The bill would not change the statutory authority of any other agency, such as the Department of Transportation or Department of Homeland Security, that currently provides oversight for portions of EMS programs, explains Upper Pine River (CO) Fire Protection District Chief Bruce Evans, a member of the NAEMT board and chair of the field bill advocacy committee.

Additionally, the bill would establish new EMS programs, enhance research initiatives and promote high-quality innovation and cost-effective field EMS. “This bill is probably the most serious change in legislation since EMS was created,” Lundy says.

Representatives were asked to cosponsor H.R. 809. On the Senate side, support was sought for a Democrat to join Idaho’s Sen. Mike Crapo in introducing the bill to that body.

A clever mechanism is being used to fund the bill. Citizens would be asked to voluntarily contribute to an EMS trust fund by checking a box on their tax return. Based on the estimated U.S. population in 2015, that would generate $321 million if every man, woman and child donated one dollar. “This bill does not add to the federal deficit,” Lundy says. “The days are over when you could ask your congressman for a $321 million appropriation.”

The bill faces opposition from the International Association of Firefighters (IAFF), which agrees with nearly all of its content but would rather see Homeland Security serve as the lead federal agency. “It’s more familiar to them,” says Lisa Tofil, NAEMT lobbyist and partner at Holland and Knight, LLP. However, she believes that with all the changes to healthcare, it’s critical that EMS be at the table with HHS divisions such as the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, Health Resources and Services Administration and others.

MIH Summit

When NAEMT first hosted EMS on the Hill in 2010, the organizers at NAEMT weren’t sure if anyone would come. “We were praying that 40 people would show up,” Lundy says. Instead, 120 people attended the inaugural event. They had 160 appointments.

“We weren’t sure how to take the first step. We just did,” Lundy says. “This year we have our helmets on. The men and women who are doing this job are making history. They aren’t waiting for someone to tell us what to do. They are creating this. It’s energizing.”

In response to feedback NAEMT received regarding the event, the association also partnered with EMS World to host a half-day Mobile Integrated Healthcare Summit, attended by more than 200 professionals. “People wanted not just a day to come and talk to elected officials, but a day to come and hear the experts in the field and gain knowledge,” Lundy says. Sessions focused on actionable information related to sustainable funding and revenue sources, and methods for measuring success and demonstrating value in MIH programs. Speakers included:

• Brent Myers, MD, MPH, FACEP, director and medical director of the Wake County EMS system, NC;

• Matt Zavadsky, MS-HSA, EMT, public affairs director, MedStar Mobile Healthcare, Ft. Worth, TX;

• Dan Swayze, DrPH, MBA, MEMS, vice president/COO, Center for Emergency Medicine of Western Pennsylvania, Inc.; and

• Ed Racht, MD, chief medical officer, American Medical Response.

Lundy admits it’s going to be a long slog to get the field EMS bill passed. Although 21 representatives have signed on to cosponsor it, he says they need 100. “I don’t mind taking on a seven-year fight if at the end we have a bill that passes—and I think we will,” Lundy says. “Years from now I’ll be proud to look back and say I was a part of that.” So will hundreds of other EMS professionals.

Teresa McCallion, EMT-B, is the managing editor of Integrated Healthcare Delivery.